Healthcare Provider Details

I. General information

NPI: 1063030989
Provider Name (Legal Business Name): BRIANA KLAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2020
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 HENLEY ST
KNOXVILLE TN
37996-5285
US

IV. Provider business mailing address

600 HENLEY ST
KNOXVILLE TN
37996-4502
US

V. Phone/Fax

Practice location:
  • Phone: 865-974-4640
  • Fax: 865-238-2034
Mailing address:
  • Phone: 909-837-7130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number6817
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: